Persistent seizures following left temporal lobe surgery are associated with posterior and bilateral structural and functional brain abnormalities

Voxel-based morphometry in the detection of dysplasia and neoplasia in childhood epilepsy: Limitations of grey matter analysis

“…[12][13][14][15][17][18][19][20][21][22][23][24] VBM is an automated and objective, voxelby-voxel examination of regional brain tissue concentration and volume in high-resolution structural MRI. [25][26][27][28] VBM has been employed in the detection and delineation of lesions in individual epilepsy patient versus control-group comparisons.…”

“…[25][26][27][28] VBM has been employed in the detection and delineation of lesions in individual epilepsy patient versus control-group comparisons. [12][13][14][15][20][21][22][23][24]29 In terms of malformations of cortical development (MCD; including FCD), VBM can detect increases in GM concentration (GMC) concordant with visible lesions on MRI and other seizure localisation data. [12][13][14][15]23 There is also some evidence that it can identify more subtle GM lesions in examples of reportedly normal MRI.…”

Bilateral reorganization of the dentate gyrus in hippocampal sclerosis

“…[3][4][5][6][7] Temporal lobectomy is an effective treatment for patients with TLE and unilateral HS with around two-thirds 3 having long-term seizure freedom. One explanation for surgical failure is a subtle abnormality in the contralateral hippocampus which becomes a secondary focus for seizures, a hypothesis supported by some EEG, quantitative MRI, 4,5 and experimental model data. 6 Studies have aimed to define cellular changes that could indicate seizure origin within the region of sclerosis.…”

Surgical and postmortem pathology studies: contribution for the investigation of temporal lobe epilepsy

“…In a series of 15 patients with idiopathic generalized epilepsy, postmortem neuropathological examination failed to disclose signs of HS, despite the long duration of epilepsy; a quantitative analysis performed in ten of these patients did not show significant differences when compared to age-matched controls 62,63 . There are a few hypotheses that try to explain why surgery fails to render TLE with MTS patients seizure free in approximately one third of cases: residual hippocampus with HS in the side of surgery; contralateral hippocampal abnormalities; or presence of epileptogenic lesion beyond the resected temporal lobe 64,65 . Whole brain studies may help evaluating these hypotheses.…”